High income doesn't always translate to high competence when it comes to Medicare.
I've been helping people navigate this complex industry for over three decades, and I still learn new things.
Throughout my career, I've found it's often those at the greatest levels of wealth who have the biggest learning curve when it comes to their health care once they turn 65.
Here are some of the most common misconceptions affluent people have about Medicare.
1. It automatically starts the day you turn 65.
This was a surprise for Michelle and Rodney Adkins of Miami.
Rodney had been an executive with IBM and was able to retire early in his 50s.
At that time, he and Michelle enrolled in the company's retirement insurance plan.
When Rodney turned 65 in August, the couple assumed his regular insurance coverage would continue through the calendar year, but as Michelle says, "He was dropped like a hot potato on his 65th birthday."
Fortunately, the two acted quickly and were able to avoid penalties, but that's largely because they already had a relationship with a broker and weren't starting from scratch.
If Rodney hadn't enrolled in a timely manner, he could have risked both a coverage gap and a costly 10% Part B surcharge for 12 months.
2. It's a terrible traveler.
Most wealthy people look forward to traveling when they retire, but Medicare coverage is incredibly limited outside of the United States.
Medicare may cover emergency care received in Mexico and Canada, but only if the closest U.S. hospital is more than 50 miles away.
There are some options for limited care overseas with select Medicare Advantage plans, but if you plan to spend a significant amount of time out of the country, travel insurance is a must.
3. The more you make, the more you pay.
Medicare Part B and Part D premiums are based on income, meaning higher earners pay more.
The income-related monthly adjustment amount, or IRMAA, is determined by the modified adjusted gross income from your tax returns two years prior.
This means for 2026 premiums, your 2024 tax return will be used to determine the amount you'll pay.
IRMAA applicability and amounts are recalculated annually. Higher IRMAA premiums are deducted from Social Security checks, which can significantly decrease a retiree's net benefit.
4. Eyes, ears, and teeth are on their own.
Most people know Medicare doesn't cover everything, but many are surprised to learn what isn't covered.
Routine vision care, including eye exams, glasses, and contacts, hearing aids and exams, and routine dental needs like cleanings, fillings, or dentures, aren't covered under original Medicare.
Some Medicare Advantage plans, or Medicare Part C plans, may cover these services, but a Medicare supplement policy, or Medigap policy, is highly recommended.
Prescription drugs also are not covered until you enroll in a separate Part D plan or a Medicare Advantage plan with Part D coverage, and there is no coverage for long-term medical and nonmedical care needs for chronic illnesses or disabilities.
If you have a client who's closing in on 65, and you yourself are not a Medicare plan advisor, I strongly suggest you begin helping the client research the options now, and ideally refer the client to a reputable broker who can help the client navigate through the Medicare wilds to find the right plan.
After all, good health is the greatest wealth of all.
Stephanie Jones is the founder and CEO of iTAV, a "software as a service" platform aimed at Medicare plan providers.
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